EMERGENCY MEDICINE DOCTOR OF WACO, PA
Osteopathic Medicine at Herwol Ave, Waco, TX

License number
Texas F9947
Category
Osteopathic Medicine
Type
Emergency Medicine
Owner
Name: JAMES PETTIT DO
Title: OWNER-PRESIDENT
Phone: (254) 752-9821
Address
Address
3721 Herwol Ave, Waco, TX 76710
National Provider ID: 1548466766
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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EMERGENCY MEDICINE DOCTOR OF WACO, PA

3721 Herwol Ave, Waco, TX 76710

Doing business as:
Emd - Waco, PA<br>Emergency Medicine Doctor of Waco, PA
Registration:
Jan 8, 2002
State ID:
0800044105
Business type:
Professional Association
Director , Member , President, Secretary:
James C. Pettit (Director , Member , President, Secretary)
Agent:
L. Hayes Fuller Iii,400 Austin Ave 8, Waco, TX 76701 (Physical)
TIN:
32035934176

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